Children Playing With Poison: Arsenic Exposure From CCA-treated Wood

Deborah L. Baptist,RN, BSN; Nan S Leslie, PhD,RN,WHNP

Disclosures

Journal for Nurse Practitioners. 2008;4(1):48-53. 

In This Article

Limiting Arsenic Exposure in Children From Contact with CCA-Treated Wood

Two common routes of arsenic ingestion include food and water.[12,13] Most of the arsenic found in food is organic and thus considered relatively non-toxic. However, preparation of food in water that contains arsenic can significantly increase the inorganic arsenic concentrations of food.[13] In the United States arsenic contamination of water is not a concern for people who use piped water systems; however, those who drink well or spring water can potentially be exposed to inorganic arsenic concentrations that are above the EPA guideline of 10 μg/L.[13] Other sources of arsenic exposure include soil (on foods and through pica activity in children), air, cigarette smoke, and pesticides such as those found in CCA-treated wood.[6,13]

Thus, although CCA-treated wood presents a possible source of arsenic exposure for young children, it is potentially easier to control than other sources of arsenic exposure such as food.[1] Education that focuses on the risks of arsenic exposure and ways to minimize exposure for persons, families, and communities is imperative. Instructional initiatives can begin in the health care setting. Nurse practitioners are ideally suited to educate both parents and children about arsenic exposure and CCA-treated wood. In a clinic setting, risk assessment and education initiatives can be integrated into a child's initial health history assessment as part of a discussion about lifestyle and health practices. Parents should be queried about a child's play activity and about family lifestyle practices in terms of outdoor play locations. Information about the risks of CCA-treated wood should be provided to parents as well as children. A risk reduction strategy such as hand washing after playing on wooden structures could be discussed with both parents and children.[7] Young children might also be taught through the use of puppets acting out a hand washing scenario.[22] Another risk reduction strategy that could be communicated to parents is to replace existing CCA-treated wood structures in their yards or to build new structures with alternatives such as cedar, redwood, or plastic.[6] Because replacing already existing decks, playsets, and so forth is expensive and not always feasible, alternatives such as an annual application of wood sealants,[2] discouraging children from playing under decks, and covering surfaces such as picnic tables with plastic-coated tablecloths to prevent contact[6] should be included in the discussion. If nurse practitioners suspects that their young patient has been exposed to arsenic poisoning from CCA-treated structures, they should contact the National Poison Control Directory at (800) 222-1222[23] or consult the web page for state-by-state poison control centers at www.aapcc.org/allctrlst/comppcclist.htm[24] to determine a treatment or referral plan for the child and family.

Communities must also be engaged in reducing the risk of arsenic exposure and CCA-treated wood. Community leaders must be made aware of the Healthy People 2010[25] priority to improve the quality of the environment and be helped to compose interventions that address the issue of arsenic exposure. The goal of the educational initiatives must be removal or sealant treatment of all CCA-treated structures in community areas such as playgrounds, public park, and so forth. In addition, communities might consider installing hand-washing stations in parks and playgrounds where children congregate.

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